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a 19 yr old male went swimming in inland pond in putero rico.within a few days he developed itching of his skin over several areas. he was unconcerned until several week later he developed lancinating pain down his leg and all toes.later he developed paraparesis and problem with bladder and bowel control,within a week he was unable to stand and had severe bladder problem.

1 clinical picture suggest subacute spinal cord injury,you could do all of the following except
a anticoagulate
b high dose steroid
c mri
d myelography
e spinal angiography

2 mri spine revealed wide spread granuloma and midst of which was an ovoid mass your diagnosis is????/

B. But I do not know the diagnosis.

you cannot anticoagulate this pt and this pt has vascular tumour over there

thanks for these intresting q.

he has ovoid mass compress the spia cord. I think u have to give steroid.
A?????

Well, actually I am not sure it is B. It can be A.

should we wait for alibi,,,there is a clue he went swiming in putero rico in a pond...

its a caudina equina syndrome n treat promptly with iv steroids b4 any further intervention.

A do all except anticoagulate
My diagnosis is spinal granuloma due fungi, protozoa.
The Q is do all of the following except. Many peolpe did not understand it that way

Initially, I was thinking of infection by parasites or protozoa, so steriods will not be appropriate. Granulomas are consistent with infection. B is still making some sense. I will still go with B because it is no longer an acute compression anymore.

Obviously, this is a terrific question. I can't wait to see the answer.